| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 700 W 47TH ST STE 100 KANSAS CITY, KS 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $11K | $18K | 6.47% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $6K | $17K | 11.70% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC. | PO BOX 632886 CINCINNATI, OH 452632886 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 4.85% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 700 W 47TH ST STE 100 KANSAS CITY, KS 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 9.04% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 3101 N CENTRAL AVE PHOENIX, AZ 85004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $3 | $2K | 3.92% |
| JB & H LLC3 Filed as: JB AND H, LLC | 8707 EAST SAGUARDO VIEW PLACE VAIL, AZ 85641 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $601 | — | $601 | 1.27% |
| JAMES D THRESHER3 Filed as: JAMES D. THRESHER | PO BOX 19569 HAPPY JACK, AZ 86024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $304 | — | $304 | 0.64% |
| MARQUEZ BENEFIT GROUP LLC3 | 8601 N BLACK CANYON HWY PHOENIX, AZ 85021 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $293 | — | $293 | 0.62% |
| KURZ & VALDEZ BENEFIT ENROLLMENT SO3 Filed as: KURZ & VALDEZ BENEFIT ENROLLMENT | 14640 N 90TH DR PEORIA, AZ 85381 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $135 | $55 | $190 | 0.40% |
| NOAH OROPEZA3 | 5305 N GINNING DR LITCHFIELD PARK, AZ 85340 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $90 | $46 | $136 | 0.29% |
| RANDELL LYNN KRUSE3 | 2018 DAYTON COURT SE RENTON, WA 98055 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $129 | — | $129 | 0.27% |
| BST COMPANIES INC3 | 319 N CAMERON VIEW PLACE TUCSON, AZ 85745 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $128 | — | $128 | 0.27% |
| R AND T FIGUEROA LLC3 Filed as: R AND T FIGUEROA, LLC | 7569 SOUTH CARLISLE AVENUE TUCSON, AZ 85746 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $112 | — | $112 | 0.24% |
| JAMES BELL3 | 540 BONAIR PL LA JOLLA, CA 92037 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $97 | $1 | $98 | 0.21% |
| JUDY INEZ BUCHOLTZ3 | 12517-217TH AVE CT E BONNEY LAKE, WA 98391 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.06% |
| V VENTURES LLC3 Filed as: V VENTURES, LLC | 8470 W CHARLESTON AVE PEORIA, AZ 85382 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.03% |
| ANDRES LOPEZ3 | 11713 SIERRA MORENA CIRCLE EL PASO, TX 79936 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.02% |
| SHAWN JEFFERY WARREN3 | 6950 WEST ROWEL ST PEORIA, AZ 85383 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 16220 N SCOTTSDALE RD SCOTTSDALE, AZ 85254 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.02% |
| DANIELS SOLUTIONS LLC3 | 13650 W HILLSBOROUGH AVE GREATER TAMPA, FL 33635 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| CORCORAN & HOYT LLC3 | 3905 TAMPA ROAD OLDSMAR, FL 33635 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 700 W 47TH STE 100 KANSAS CITY, KS 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 13.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR,INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $649K |
| CBIZ BENEFITS & INS SERVICES INC EIN 31-1582098 BROKER | Other commissions Service code 55 | — | $70K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 884 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 884 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,238 | $80K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 884 | $199K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 884 | $276K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 884 | $42K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 884 | $247K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,238 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.